Get Hemovigilance Intent To Participate Form - Aabb - Aabb

This guide provides a clear and supportive approach to completing the Hemovigilance Intent To Participate Form from AABB online. By following the instructions below, users will be equipped to submit their participation in the biovigilance initiative effectively.

Follow the steps to successfully complete the Hemovigilance Intent To Participate Form.

1. Click the ‘Get Form’ button to access the Hemovigilance Intent To Participate Form and open it for editing.
2. Begin by indicating your facility's intent to participate in the CDC’s NHSN Hemovigilance Module by selecting the appropriate checkbox on the form.
3. If your facility requires additional details about utilizing Hemovigilance data for benchmarking and quality improvement, you can select the corresponding checkbox.
4. Fill in the contact name in the designated field to identify the representative from your facility.
5. Enter the name of your organization in the appropriate section.
6. Provide your title in the specified field to detail your position within the organization.
7. Indicate the total number of red blood cell units transfused annually by entering the figure in the relevant field.
8. List the total number of red blood cell units collected annually in the corresponding section.
9. Complete the address section, ensuring you include the street address, city, state, and zip code.
10. Provide a contact phone number for further communication.
11. Sign the form in the designated area to confirm your submission and intentions.
12. Enter your email address to facilitate communication regarding your participation.
13. Record the date of completion in the space provided.
14. If you agree to have your organization's name included in the list of participating facilities, check the corresponding box.
15. Once all sections are completed, save changes to the form, and you may download, print, or share the completed document as needed.

Submit your Hemovigilance Intent To Participate Form online today to contribute to the biovigilance initiative!